The island of Ischia: Glorious mud

Dr Paolo Magrassi is passionate about mud. Not, he explained with a dismissive flick of the hand, that common-or-garden variety, that muck. His mud contains a therapeutic array of minerals, he continued, brandishing an A4-length list under my nose to prove his point. Once cultivated, it is washed with thermal waters and tended for a year so the healthy bacteria and algae can reach maturation.

It is the mud that emanates from the rich volcanic soils of Ischia, an island in the Gulf of Naples that has drawn health-conscious disciples since Roman times. Centuries of bathers cannot be wrong. Certainly, the Italian Ministry of Health doesn't think so. The country is one of the few that treats thermal medicine so seriously that it is an acknowledged branch of medicine and specialisation. Six years ago, 1.2 million patients signed up for medicina termale in Italy, half on the national health system; the last three years has seen a clear trend for greater numbers of younger people using thermal centres.

Dr Magrassi's patients return year after year with prescriptions from their doctors for rehabilitation or to treat a variety of afflictions such as skin complaints, respiratory illnesses and stomach problems. One might think that a doctor who spent his early career as a cardiac surgeon in New York or in dangerous spots such as Angola, would find his new post in charge of the medical side of a spa in a luxurious hotel on a beautiful island in the Tyrrhenian Sea a relaxing post. It seems not. To illustrate his point he looked down morosely at the pile of detailed geological reports in front of him.

The spa at L'Albergo della Regina Isabella is looking for a new spring and five have been tested. This is no simple matter. Temperatures and mineral content must all be assessed, Dr Magrassi explained with classic Italian pathos. His patients require the best care and, of course, there are those who turn up for beauty treatments, "to look younger" he added, attempting not to sound too disdainful.

But it is the beautiful people that made the Regina Isabella and Ischia famous. In the Fifties, when media tycoon and film producer Angelo Rizzoli opened the hotel, such luminaries as Elizabeth Taylor, Maria Callas and Jack Lemmon were regular guests. Today the stars' names are discreetly engraved on brass plaques outside the suites.

Dr Magrassi's mud may be detoxifying but it is also warm, sensuously smooth and rather delightful – gain without the pain. Certainly, a hotel that prides itself on its butler service and includes champagne next to the freshly squeezed fruit juice at breakfast is not a place of denial. One may be detoxifying but that does not prohibit diving into the wine list; each glass is accompanied by a greedy array of Italian delicacies. The guests at the Regina Isabella patently do not do discomfort. Judging by the butler sombrely transporting a velvet headband on a silver tray to a lady suffering a bad hair day, no request is too trivial.

First colonised by the Greeks in the 8th century BC, the island and its thermal waters have been famous since the Romans discovered these liquid gold mines in the subsoil. Today Ischia is undeservedly overshadowed by its sister island Capri. But this relative obscurity has left it to flourish without too much interference – and allowed it to retain a thoroughly Mediterranean feel.

When the director and producers of The Talented Mr Ripley wanted to evoke authentic Fifties Capri, they turned to Ischia for several scenes. Yet British and American tourists appear to have barely discovered this fertile gem. While there are a few German visitors, and designer shops abound in the main town of Ischia Porto, the island retains an old-fashioned feel. Old men leaning on walking sticks debate enthusiastically in the cobbled square in Lacco Ameno in the evenings as their wives sit praying in church; young men on scooters hang around on corners, chatting up Sophia Loren lookalikes.

Occasionally the odd traffic jam clogs up the main street, as a local policeman stands rigidly, his white-gloved hand holding back the oncoming vehicles while one of the village's more ancient residents makes snail-like progress across the road.

Thermal spas to suit every need and wallet pepper Ischia, and they comprise its main claim to fame. But to ignore its other charms would be shameful. Boat tours offer delightful views of the spectacularly rocky coastline, the quiet beaches, fishing villages and pine groves of the 46 square kilometres known as the "green island". But it is the small local buses that circle its coast clockwise and anti-clockwise which provide the best insight into Ischia's true nature.

Perhaps ill-advisedly, I opted to travel at lunchtime when the island's school children and commuters were heading home. As the already jammed bus lurched to a halt, the waiting crowd surged forward. Everyone squeezed intimately next to strangers on the vehicle, roaring with laughter at what must be a daily ritual. The giggles turned to cheers as a hapless schoolboy became trapped in the pincer movement of the closing doors. Swiftly the driver reopened the doors, dumping the child unceremoniously on to the pavement before speeding off. Minutes later a car shot out of a hidden side alley, causing the bus to swerve precariously towards the edge of the mountain road. The passengers applauded with glee.

Squeezing through flesh, I dismounted first in Forio, the centre of the island's wine industry. Above the pretty fishing port lies La Mortella, the home of the late British composer Sir William Walton where his widow Susana has created a magical award-winning garden – a wonderland of tropical blooms, humming birds and hideaways where the sound of his music wafts through a Thai pagoda, nymphaeum, small tea room and sun temple.

Later, in Lacco Ameno, I visited Villa Arbusto, once the home of Angelo Rizzoli, and now one of the most eclectic museums in the world. An impressive display of the archaeological finds from the Greek settlement of Pithecusae (including Nestor's Cup made famous in verses from Homer's Iliad and bearing an inscription said to be the earliest known example of Greek) sits alongside Rizzoli's private collection of African art, a display of Sixties photographs from Ischia's celebrity heyday – featuring the great man beaming next to everyone from John Wayne to the Pope – as well as an exhibition dedicated to cetaceans.

On the other side of the island, Sant'Angelo provides the delights of dockside cafés, art galleries and water taxis which ferry bathers to small coves. But Sant'Angelo is also a magnet for sun worshippers, day trippers from Capri and those piloting yachts or gin palaces across the Mediterranean, which means that its quaint streets soon filled up with visitors brandishing ice creams.

Escaping the tourists, however, was but a matter of hopping back on the bus and speeding up a mountain road past neat little vineyards and through a village, all of whose inhabitants appeared to be waving white balloons as a young bride and groom were emerging from a church to loud cheers.

Onwards and upwards: I reached the peaceful hamlet of Fontana, a collection of a few grocery shops and a picturesque ochre church set around a tiny square, perched precariously on the side of a hill. From here there is easy access to Mount Epomeo, the slumbering volcano that last erupted in 1301 but still dominates the island. At 2,600ft, it is minnow compared with the might of Mount Vesuvius, which rises on the horizon back on the mainland.

I made the (rarely arduous) ascent in less than an hour, through green forests bustling with lizards and onwards into a moon-like volcanic landscape. Eschewing the small restaurant at the summit, I headed for the rocky outcrop at the peak.

Sitting in solitary splendour, relishing the soothing breeze and almost perfect silence, I surveyed the whole of Ischia, as well as its sister islands of Capri and Procida. Three short days on the island had replaced stress with serenity. How had it come about? Was it the delightful nonchalance of the locals? Or copious quantities of local wine? Perhaps it was just the satisfaction of scaling a small volcano. The answer seemed as clear as Dr Magrassi's marvellous mud. But whatever the reason, Ischia had worked its magic upon me.

Traveller's Guide

Getting there

The nearest international airport is Naples, which is served by a variety of airlines from the UK. The writer travelled with easyJet (0905 821 0905; www.easyJet.com), which flies daily from Stansted.

Capodichino airport is approximately 20 minutes from Harbour Beverello port by taxi or public bus line Alibus, where several companies provide transfer to Ischia via hydrofoil (approximately 30 minutes) or slower car ferry. For timetables and costs for Snav hydrofoils check on www.snav.it and ferries on www.caremar.it or www.traghettipozzuoli.it.

Staying there

L'Albergo della Regina Isabella, 1 Piazza Santa Restituta, 80076 Lacco Ameno (00 39 081 99 43 22; www.reginaisabella.it).

The Thermal Spa is open late-March to mid-November as well as a fortnight from the end of December. Standard single room rates start at €118 (£93) per night and doubles at €190 (£158), including breakfast, the use of three swimming pools, beach, fitness centre, solarium and tennis courts. Junior suites start at €618 (£515) per night.

Seeing the island

Captain Morgan's boat offers a three-hour tour stopping off at Sant'Angelo for €15 (£12.50). Tel: 00 39 081 98 50 80.

Trips around the island or to nearby Capri and Procida can also be organised with the Linee Rumore Marittima (www.rumoremarittima.it; 00 39 081 98 36 36).

Tickets for the regular local buses which travel clockwise (CD) and anti-clockwise (CS) around the island can be bought from local shops for €1.20 (£1) valid for 90 minutes travel. An all-day, multi-use ticket costs €4 (£3.30).

More information:

Visit www.ischiaonline.it for English-language information and links about the island.